Effect of a food supplementation and psychosocial stimulation trial for severely malnourished children on the level of maternal depressive symptoms in Bangladesh B. Nahar,*† I. Hossain,*‡ J. D. Hamadani,§ T. Ahmed,*‡ S. Grantham-McGregor¶ and L.-A. Persson† *Centre for Nutrition and Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh †International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden ‡James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh §Centre for Child and Adolescent Health (CCAH), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh, and ¶Centre for International Health and Development (CIHD), Institute of Child Health, University College London, London, UK Accepted for publication 4 June 2014 Keywords Bangladesh, food supplementation, maternal depressive symptoms, psychosocial stimulation, severe malnutrition Correspondence: Baitun Nahar, CNFS, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka-1212, Bangladesh E-mail: baitun@icddrb.org, baitun.nahar@kbh.uu.se, baitunnahar@yahoo.com Abstract Background Maternal depression is associated with poor child development and growth in low-income countries. This paper evaluates the effect of a community-based trial providing psychosocial stimulation and food supplements to severely malnourished children on maternal depressive symptoms in Bangladesh. Methods Severely underweight (weight-for-age Z-score <-3) hospitalized children aged 6–24 months (n = 507), were randomly assigned to: psychosocial stimulation (PS), food supplementation (FS), PS+FS, clinic control (CC) and hospital control (CH) at discharge. PS included play sessions with children and parental counselling to mothers during fortnightly follow-up visit at community clinics, conducted by trained play leaders for 6 months. FS involved cereal-based supplements (150–300 kcal/day) for 3 months. All groups received medical care, micronutrient supplements and growth monitoring.We used Bayley scales, Home Observation for Measurement of Environment (HOME) inventory and a parenting questionnaire to assess child development, home stimulation and mothers’ child-rearing practices, respectively.We assessed mothers’ depressive symptoms using a modified version of Centre for Epidemiologic Studies Depression Scale at baseline and at 6 months post intervention. Results Maternal depressive symptoms were significantly lower in the CH group at baseline (P = 0.014). After 6 months of intervention there was no significant effect of intervention after adjusting for baseline scores and all possible confounders. Maternal depressive symptoms were higher among poorer (P = 0.06), older (P = 0.057) and less educated (P = 0.019) mothers, who were housewives (P = 0.053), and whose husbands had more unstable jobs (P = 0.058). At 6 months post intervention, children’s cognitive (P = 0.045) and motor (P = 0.075) development, HOME (P = 0.012) and mother’s parenting score (P = 0.057) were higher among mothers with lower depressive symptoms. Child: care, health and development Original Article doi:10.1111/cch.12176 483 © 2014 John Wiley & Sons Ltd